Unconscious patients get leg-up with cycling

Unconscious patients in intensive care have been placed on motorised cycling machines at the Austin Hospital as part of a trial to establish if exercise improves recovery rates.

It is done with the help of physiotherapists, who strap the unconscious patients to the pedals, which do the work. Eight patients used cycling machines five times a week for an hour a day while lying in bed.

Ultrasounds were taken to establish each patient's muscle mass. This was compared with measurements taken when they left intensive care. The eight participating patients' results were then compared with another eight patients of similar condition who had not cycled while in intensive care.

Researchers found the eight who exercised in intensive care reached recovery milestones such as standing and walking faster, had reduced delirium and improved physical function compared with their peers who did not. They were also able to return home up to three weeks earlier.

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Austin Hospital ICU patient Brian Higgins is part of a trial to improve recovery rates by exercising while they are still unconscious.Credit:Jason South

The study, the first of its kind in the world, will now be expanded to assess up to 80 patients.

Austin Hospital intensive care physiotherapist Selina Parry said a week in ICU could result in the loss of up to 25 per cent of muscle mass.

Imported from America, the cycling machines use electrode pads to artificially stimulate four muscles: the quadriceps, hamstring, calf and gluteals. The exercise regime focused on the legs because they were the largest muscle group and susceptible to muscle loss during inactivity.

''We really are interested in exercising early, rather than trying to play catch-up,'' she said. ''It's much harder to rehabilitate patients if they are really weak.''

Ideally, she said, patients should be exercising three to four days after admission. ''Traditionally people have believed that rest gets you better. But what we now know is that activity and movement plays a critical role.''

Melbourne University's head of physiotherapy, Linda Denehy, led the research with Austin Health's manager of physiotherapy, Sue Berney.

Professor Denehy said the benefit of exercise was increasingly being acknowledged as a technique to boost recovery rates. ''It's an emerging area and Australian physiotherapists are really world leaders in this,'' she said.

Professor Denehy said exercise had also been shown to benefit patients undergoing cancer treatment, with chemotherapy side effects such as fatigue and nausea reduced. Patients with chronic diseases such as diabetes, lung and heart disease as well as neurological conditions have also been shown to benefit from exercise.